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A systematic review and meta-analysis following PRISMA 2020 and PROSPERO registration assessed systemic immune-inflammation index (SII), lymphocyte-to-monocyte ratio (LMR), and related neutrophil- or platelet-based ratios, using studies reporting survival outcomes (OS and/or PFS) via hazard ratios. Thirty-six studies (10,325 patients) showed that higher NLR and PLR predicted worse survival, higher LMR predicted better survival, and higher SII predicted poorer OS.",{"@graph":14,"@context":73},[15,34,56],{"@type":16,"itemListElement":17},"BreadcrumbList",[18,23,27,31],{"item":19,"name":20,"@type":21,"position":22},"https://docshare.wps.com","Home","ListItem",1,{"item":24,"name":25,"@type":21,"position":26},"https://docshare.wps.com/document/","Document",2,{"item":28,"name":29,"@type":21,"position":30},"https://docshare.wps.com/document/healthcare/","Healthcare",3,{"item":32,"name":10,"@type":21,"position":33},"https://docshare.wps.com/document/immune-inflammation-index-as-prognostic-markers-in-metastatic-castration-resistant-prostate-cancer-a-systematic-review-and-meta-analysis/356768/",4,{"url":32,"name":10,"@type":35,"image":36,"author":41,"headline":10,"publisher":44,"fileFormat":47,"inLanguage":8,"description":12,"dateModified":48,"datePublished":49,"encodingFormat":47,"isAccessibleForFree":50,"interactionStatistic":51},"DigitalDocument",{"url":37,"@type":38,"width":39,"height":40},"https://docshare.wps.com/thumbnails/immune-inflammation-index-as-prognostic-markers-in-metastatic-castration-resistant-prostate-cancer-a-systematic-review-and-meta-analysis/356768.png","ImageObject",300,407,{"name":42,"@type":43},"Aditya","Person",{"url":19,"name":45,"@type":46},"DocShare","Organization","application/pdf","2026-10-28","2026-09-23",true,{"@type":52,"interactionType":53,"userInteractionCount":55},"InteractionCounter",{"@type":54},"ViewAction",15,{"@type":57,"mainEntity":58},"FAQPage",[59,65,69],{"name":60,"@type":61,"acceptedAnswer":62},"Which immune-inflammation indices were evaluated for prognosis in mCRPC?","Question",{"text":63,"@type":64},"The review assessed the systemic immune-inflammation index (SII), lymphocyte-to-monocyte ratio (LMR), and ratios derived from neutrophils or platelets to lymphocytes.","Answer",{"name":66,"@type":61,"acceptedAnswer":67},"What overall sample size and study count were included in the meta-analysis?",{"text":68,"@type":64},"The meta-analysis included 36 studies comprising 10,325 patients with metastatic castration-resistant prostate cancer.",{"name":70,"@type":61,"acceptedAnswer":71},"How did different indices relate to overall survival (OS) and progression-free survival (PFS)?",{"text":72,"@type":64},"Higher NLR and PLR predicted worse OS and PFS, higher LMR predicted improved OS, and higher SII predicted worse OS; subgroup analyses supported robustness for NLR/PLR where feasible.","https://schema.org",{"og:url":32,"og:type":75,"og:title":10,"og:site_name":45,"og:description":12},"article",{"robots":77,"canonical":32},"index,follow",{"doc_id":79,"site_id":7},356768,1790167679,{"code":4,"msg":82,"data":83},"success",[84,88,92,96,101,106,110,115,120,123,127],{"id":22,"doc_module":4,"doc_module_name":25,"category_name":85,"show_sort_weight":86,"slug":87},"Story & Novel",90,"story-novel",{"id":26,"doc_module":4,"doc_module_name":25,"category_name":89,"show_sort_weight":90,"slug":91},"Literature",80,"literature",{"id":33,"doc_module":4,"doc_module_name":25,"category_name":93,"show_sort_weight":94,"slug":95},"Exam",70,"exam",{"id":97,"doc_module":4,"doc_module_name":25,"category_name":98,"show_sort_weight":99,"slug":100},5,"Comic",60,"comic",{"id":102,"doc_module":4,"doc_module_name":25,"category_name":103,"show_sort_weight":104,"slug":105},6,"Technology",50,"technology",{"id":107,"doc_module":4,"doc_module_name":25,"category_name":29,"show_sort_weight":108,"slug":109},7,40,"healthcare",{"id":111,"doc_module":4,"doc_module_name":25,"category_name":112,"show_sort_weight":113,"slug":114},8,"Research & Report",30,"research-report",{"id":116,"doc_module":4,"doc_module_name":25,"category_name":117,"show_sort_weight":118,"slug":119},9,"Religion & Spirituality",20,"religion-spirituality",{"id":118,"doc_module":4,"doc_module_name":25,"category_name":121,"show_sort_weight":118,"slug":122},"World Cup","world-cup",{"id":124,"doc_module":4,"doc_module_name":25,"category_name":125,"show_sort_weight":124,"slug":126},10,"Lifestyle","lifestyle",{"id":128,"doc_module":4,"doc_module_name":25,"category_name":129,"show_sort_weight":97,"slug":130},19,"General","general",{"code":4,"msg":82,"data":132},{"doc_id":79,"user_id":133,"nickname":42,"user_avatar":134,"doc_module":4,"category_id":107,"category_name":29,"doc_title":10,"doc_description":12,"doc_content":135,"file_id":136,"file_url":137,"file_type":138,"file_size":139,"view_count":55,"is_deleted":4,"is_public":22,"is_downloadable":22,"audit_status":22,"page_count":55,"language":140,"language_code":8,"site_id":7,"html_lang":8,"table_of_contents":141,"faqs":142,"seo_title":143,"seo_description":12,"update_tm":144,"read_time":145},962085564549,"https://ap-avatar.wpscdn.com/davatar_085a072bc5b1113ac321206ff7593b45","TYPE Systematic Review PUBLISHED 27 April 2026  \nDOI 10.3389/fonc.2026.1806929  \nOPEN ACCESS  \nEDITED BY  \nRonald M. Bukowski,  \nCleveland Clinic, United States  \nREVIEWED BY  \nOzcan Yildiz,  \nBiruni University, Türkiye Piyush Aggarwal, Sri Aurobindo University, India  \n*CORRESPONDENCE  \nChenhao Guo  \n [ldyyguoch@163.com](ldyyguoch@163.com)[ ](ldyyguoch@163.com)Weiping Li  \n [ldyy_liwp@lzu.edu.cn](ldyy_liwp@lzu.edu.cn)  \n†These authors have contributed equally to this work  \nRECEIVED 08 February 2026  \nREVISED 02 April 2026  \nACCEPTED 02 April 2026  \nPUBLISHED 27 April 2026  \nCITATION  \nQin Z, Liu R, Jing S, Guo C and Li W (2026) Immune-inflammation index as prognostic markers in metastatic castration-resistant prostate cancer:  \na systematic review and meta-analysis. Front. Oncol. 16:1806929 .  \ndoi: 10.3389/fonc.2026.1806929  \nCOPYRIGHT  \n© 2026 Qin, Liu, Jing, Guo and Li. This isan open-access article distributed under the terms of the Creative Commons Attribution License (CC BY) . The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.  \nImmune-inflammation index as prognostic markers in metastatic castration-resistant prostate cancer: a systematic review and meta-analysis  \nZitong Qin 1†, Runzhang Liu 1†, Suoshi Jing 2, Chenhao Guo 2* and Weiping Li 2*  \n1The First Clinical Medical College of Lanzhou University, Lanzhou, China, 2 Department of Urology, The First Hospital of Lanzhou University, Lanzhou, China  \nIntroduction: Systemic inflammation is closely linked to tumor progression and immune dysfunction. Simple blood-derived immune-inflammatory indices may provide cost-effective prognostic stratification for metastatic castration-resistant prostate cancer.  \nMethods: This systematic review and meta-analysis followed PRISMA 2020 and was registered in PROSPERO. Electronic databases, including Embase, PubMed, Web of Science, and the Cochrane Library, were queried from inception until May 2025. Eligibility was restricted to research comparing high and low strata of the systemic immune-inflammation index (SII), lymphocyte-to-monocyte ratio (LMR), and ratios of neutrophils or platelets to lymphocytes, provided they reported survival outcomes (OS and/or PFS) via hazard ratios (HRs) and 95% confidence intervals (CIs) . Random-effects models were applied according to heterogeneity; subgroup, sensitivity, and publication-bias analyses were performed.  \nResults: 36 studies involving 10,325 patients with mCRPC were included. Elevated NLR was associated with worse OS (pooled HR = 1.77, 95% CI 1.59–1.97) and PFS (pooled HR = 1 .51, 95% CI 1 .31–1.75) . Higher PLR predicted shorter OS (pooled HR = 1 .57, 95% CI 1 .35–1. 84) and PFS (pooled HR = 1 .45, 95% CI 1 .13–1. 87) . Higher LMR was associated with improved OS (pooled HR = 0.45, 95% CI 0.31–0.67), while higher SII predicted worse OS (pooled HR = 2 . 22, 95% CI 1 .86–2. 66) . Subgroup analyses (where feasible) supported the robustness of NLR/PLR associations across several clinical strata, though some subgroups were limited by small numbers. Conclusion: Blood-based immune-inflammatory indices (NLR, PLR, SII, LMR) are significantly associated with survival outcomes in mCRPC. These readily available markers may aid risk stratification and inform individualized management, while prospective validation and standardized cut-offs remain needed.  \nSystematic Review Registration: [https://www.crd.york.ac.uk/prospero/display_](https://www.crd.york.ac.uk/prospero/display_)[record.php?RecordID=1291003](record.php?RecordID=1291003), [identi](identi)fi[er CRD420261291003](er CRD420261291003) .  \nKEYWORDS  \nlymphocyte-to-monocyte ratio, meta-analysis, metastatic castration-resistant prostate cancer, neutrophil-to-lymphocyte rati","cbCaillG9xBgZvKG","https://ap.wps.com/l/cbCaillG9xBgZvKG","pdf",3793888,"English","# Introduction\n# Methods\n# Results\n# Conclusion\n# Systematic Review Registration\n# Keywords","[{\"question\":\"Which immune-inflammation indices were evaluated for prognosis in mCRPC?\",\"answer\":\"The review assessed the systemic immune-inflammation index (SII), lymphocyte-to-monocyte ratio (LMR), and ratios derived from neutrophils or platelets to lymphocytes.\"},{\"question\":\"What overall sample size and study count were included in the meta-analysis?\",\"answer\":\"The meta-analysis included 36 studies comprising 10,325 patients with metastatic castration-resistant prostate cancer.\"},{\"question\":\"How did different indices relate to overall survival (OS) and progression-free survival (PFS)?\",\"answer\":\"Higher NLR and PLR predicted worse OS and PFS, higher LMR predicted improved OS, and higher SII predicted worse OS; subgroup analyses supported robustness for NLR/PLR where feasible.\"}]","Immune-inflammation index as prognostic markers in metastatic castration-resistant prostate cancer - a systematic review and meta-analysis | PDF",1790127186,38]